Healthcare Provider Details

I. General information

NPI: 1730124942
Provider Name (Legal Business Name): MERCY HEALTH-ST CHARLES HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 SANDUSKY ST
PERRYSBURG OH
43551-3120
US

IV. Provider business mailing address

2200 JEFFERSON AVE 4TH FLOOR
TOLEDO OH
43624-1120
US

V. Phone/Fax

Practice location:
  • Phone: 419-872-3232
  • Fax:
Mailing address:
  • Phone: 419-251-8997
  • Fax: 419-251-3353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA PLATZKE
Title or Position: CFO
Credential:
Phone: 419-251-2046